Cardiac and lung transplantation and the right heart

Pulmonary hypertension and right-heart dysfunction commonly accompany both advanced left-heart failure and advanced lung disease, with important implications for prognosis and management. A consistent, stepwise approach to understanding particular patient phenotypes, and the interpretation and modulation of hemodynamics, is necessary in order to optimize decision-making and outcome in patients being considered for cardiac or lung transplantation. For patients with pulmonary arterial hypertension who are being considered for lung or heart-lung transplantation, multiple critical factors relating to timing of transplantation, optimal perioperative management, and particular lung allocation scheme in a given country must be carefully considered in order to optimize the outcome for these patients.